1a: Osteoporosis (thinning of the bones), and ischaemic heart disease
(narrowing of arteries in the heart) are both common conditions associated
with an enormous burden of ill health and decreased survival across the
population. Recent studies have suggested that people who have osteoporosis
are more likely to have narrowing of their arteries and are also likely to die
earlier than those who do not. However such studies have usually been small
and unable to investigate potential underlying mechanisms. We will use the
whole UK Biobank cohort to initially explore the relationships between
baseline measures of bone density (heel ultrasound), and risk
1b: factors for heart attacks and strokes such as blood pressure, pulse wave
velocity and aortic stiffness and pre-existing heart disease, whilst controlling
for other factors such as coexisting disease, medications, lifestyle, physical
activity and family history. We will then investigate, when the assay results
become available, whether these relationships are mediated via markers of
chronic inflammation and other factors such as vitamin D and sex-hormone
levels. We will also request data on new cardiovascular events such that after 5
years, longitudinal associations can be explored.

PROJECT EXTENSION – APPROVED BY UK BIOBANK 03.11.2016
The abdominal MRI gives a much more refined measure of both visceral and subcutaneous adipose tissue and a more accurate volumetric measure of muscle mass, so clearly of major importance in the associations between bone and cardiovascular health.

Project extension:

Osteoporosis (thinning of the bones), and ischaemic heart disease (narrowing of arteries in the heart) are both common conditions associated with an enormous burden of ill health and decreased survival across the population. Recent studies have suggested that people who have osteoporosis are more likely to have narrowing of their arteries and are also likely to die earlier than those who do not. However such studies have usually been small and unable to investigate potential underlying mechanisms. We will use data from the whole UK Biobank cohort to initially explore the relationships at recruitment between previous broken bone (the major consequence of osteoporosis) and baseline measures of bone health including bone density (heel ultrasound, DXA) on the one hand, and previous cardiovascular events and risk factors for heart attacks and strokes such as blood pressure, pulse wave velocity and aortic stiffness, MRI indices, on the other, whilst controlling for other factors such as coexisting disease, medications, lifestyle, physical activity and family history. We will then investigate, when the assay results become available, whether these relationships are mediated via markers of chronic inflammation and other factors such as vitamin D and sex hormone levels. We will explore the potential to use novel epidemiological methods, using genotype data (which will become available) to establish whether changes in blood markers might actually cause increased risk of fractures or cardiovascular disease. We also request linked NHS data on new fractures and cardiovascular events such that longitudinal associations can be explored.

There is increasing evidence that early development plays a role in the establishment of the risks of cardiovascular disease and osteoporosis. In addition to exploring whether associations between bone and cardiovascular health measures are influenced by early developmental measures, we will undertake analyses investigating associations between early life measures, for example birthweight, and measures of bone/cardiovascular health.